Steam Boiler Safety Checklist
Complete this checklist to ensure all critical steam boiler safety items are inspected and documented.
Inspector Name
*
First Name
Last Name
Inspector Email
*
example@example.com
Inspection Date and Time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Boiler Identification Number
*
Boiler Location
*
Inspection Checklist
*
Rows
Pass
Fail
N/A
Pressure relief valve functional
1
2
3
Water level controls operational
4
5
6
No leaks detected
7
8
9
Safety valves tested
10
11
12
Burner operation normal
13
14
15
Emergency shutoff accessible
16
17
18
Gauges and indicators readable
19
20
21
Boiler room ventilation adequate
22
23
24
Are there any safety concerns requiring immediate attention?
*
Yes
No
Comments or Corrective Actions Needed
Overall Boiler Safety Status
*
Safe to Operate
Unsafe – Requires Immediate Attention
Requires Monitoring
Inspector Signature
*
Submit Checklist
Submit Checklist
Should be Empty: